What it takes to become a licensed nursing home administrator in Texas, where the license is called Nursing Facility Administrator (NFA): the degree routes, the Administrator-in-Training (AIT) internship, the NAB and Texas exams, fees, CE, renewal and finding a preceptor. Figures come from HHSC, the Texas rules and NAB, with section numbers.
| Who licenses | Texas Health and Human Services Commission (HHSC), NFA Licensing Branch, 512-438-2015. A governor-appointed committee advises HHSC (HSC § 242.303) |
|---|---|
| License title | Nursing Facility Administrator (NFA), Texas’s name for a nursing home administrator |
| Standard education | Bachelor’s degree in any subject plus 12 semester credit hours in long-term care administration (26 TAC § 555.12(a)(1)) |
| AIT requirement | 1,000 hours on the standard route; 500 on three degree-plus-experience routes; none with NAB’s Health Services Executive (HSE) qualification (§§ 555.12, 555.13) |
| National exams | NAB Core of Knowledge + NHA Line of Service on the degree routes, a scaled 113 to pass each; $480 for the two, paid to NAB. HSE holders skip them (§ 555.18(b)) |
| State exam | Required on every route: the state examination on nursing facility requirements in Texas (NAB: NHA-TX), two hours, $210, through NAB and Pearson VUE after HHSC approval (§ 555.18) Details ↓ |
| Continuing education | 40 hours per two-year license, including at least 6 in ethics and the HHSC infection control and PPE course (§ 555.35) |
| Renewal | Every two years from the date issued, $250, with fingerprints (§§ 555.31(c), 555.34) |
| HHSC fees | $100 application and $250 license (§ 555.3) |
| Official sources | hhs.texas.gov (HHSC) · 26 TAC Chapter 555 (mirror) · 26 TAC Chapter 554 (mirror) · nabweb.org (national exams) |
Verified against the sources above, September 2026. Rules are cited as 26 TAC (Texas Administrative Code) and HSC (Health and Safety Code). Requirements change; the current rules, as HHSC applies them, govern, so confirm with the NFA Licensing Branch before you apply.
In Texas the licensing body is a state agency. The Health and Human Services Commission licenses you (§ 555.2). The Nursing Facility Administrators Advisory Committee, “appointed by the governor”, advises HHSC on NFA licensing but does not license anyone (HSC § 242.303).
The NFA Licensing Branch (512-438-2015) handles licensure, renewals and reciprocity; Credentialing and Registry Enforcement (CARE, 512-438-5495) handles enforcement and sanctions, including prior approval of CE ordered as a sanction; complaints go to HHSC, using the contact details on its website (§ 555.51). Applications, internships and renewals all run through TULIP, the Texas Unified Licensure Information Portal (§ 555.2).
26 TAC § 555.12(a) sets out the routes. Your degree and experience set your internship hours and exams:
| Route | Education | Experience | Internship | Exams |
|---|---|---|---|---|
| (a)(1) | Bachelor’s in any subject, plus 12 semester credit hours in long-term care administration covering NAB’s four domains | None | 1,000 hours | State + NAB |
| (a)(2) | Bachelor’s in health administration, health services administration, health care administration or nursing, with coursework in the four domains | 3 years of management experience | 500 hours | State + NAB |
| (a)(3) | Bachelor’s with coursework in the four domains | 1 year as assistant administrator of record or administrator of record in another state | 500 hours | State + NAB |
| (a)(4) | Master’s in one of the (a)(2) fields, with coursework in the four domains | 1 year of management experience | 500 hours | State + NAB |
| (a)(5) | NAB’s Health Services Executive (HSE) qualification, with no license ever revoked | Not listed | None | State exam only |
A sixth route, § 555.12(a)(6), covers administrators licensed in another state who meet one of routes (1) to (4); see reciprocity below. The 12 credit hours were 15 until the 6 December 2023 amendments. HHSC’s “Become a Texas NFA” page describes the experience for the 500-hour routes as “in a nursing facility”, while the rule says only “management experience”. If yours is outside a nursing facility, ask the NFA Licensing Branch. The (a)(1) degree must come from a college or university accredited by an agency the Texas Higher Education Coordinating Board (THECB) recognizes; foreign degrees count if AACRAO-recognized accredited universities accept them as transfer credit (§ 555.12(b)).
Every applicant also needs:
The Administrator-in-Training (AIT) internship is 1,000 hours on the standard route and 500 hours on routes (a)(2) to (a)(4). HSE holders do no internship (§ 555.12(a)(5)). The conditions are in 26 TAC § 555.13(a):
An internship done in another state can count if it was part of a NAB-accredited program, or was approved by that state with at least 1,000 hours, or 500 in cases the rule specifies (§ 555.13(b)). Military service, training or education that is “substantially similar” can count toward it (§ 555.42(e)). Chapter 555 sets no deadline for finishing the internship and no department rotation schedule, so agree your plan with your preceptor. Once you file your licensure application, it is valid for one year (§ 555.11(d)).
Three consecutive failures of the state exam or the NAB exams mean “an additional 1,000-hour administrator-in-training internship” before you test again (§ 555.18(j)).
Under § 555.15 a preceptor is licensed “as an NFA for a minimum of five years, with the two most recent years in Texas”, has completed HHSC-approved preceptor training, and has applied through TULIP. HHSC’s preceptor page adds that the training costs $15 and “There is no cost for the preceptor certification.” Certification lasts “two years from the date HHSC certifies the preceptor” (§ 555.14(g)). The preceptor needs HHSC approval to sponsor each AIT, and again “before sponsoring more than one AIT at the same time” (§ 555.14(a), (c)). In return, “HHSC waives 20 of the 40 hours of continuing education” for a preceptor who sponsors an AIT (§ 555.14(f)).
Other states: AIT Hours by State.
The free AIT Planner turns your internship hours into a plan across facility departments. The department split is our planning aid, not a Texas rule, so agree it with your preceptor. No account needed.
Open the free AIT PlannerOn routes (a)(1) to (a)(4), § 555.18(a) requires the Texas state exam and “the NAB examinations”, which HHSC describes as “two exams (core and the NFA line of service)”. HSE holders take only the state exam (§ 555.18(b)). NAB is the National Association of Long Term Care Administrator Boards, and its exams are delivered by Pearson VUE. Figures from NAB’s Candidate Handbook (revised September 2026):
| Core of Knowledge | 125 questions (100 scored), 2 hours 30 minutes in all (2 hours 10 minutes to answer questions); $320 alone |
|---|---|
| NHA Line of Service | 75 questions (60 scored), 1 hour 30 minutes in all (1 hour 10 minutes to answer questions); $190 alone |
| Both together | $480 from 1 February 2026, up from $455 |
| Passing score | “a scaled score of 113” on each |
| Attempts | Since 1 January 2026, up to 4 per cycle (1 July to 30 June) |
| Where | Pearson VUE test centers, (800) 834-1426 |
You register “at the designated NAB website”, and “An applicant must not take any examination without HHSC approval” (§ 555.18(c), (e)). Each attempt means paying again (§ 555.18(i)). Accommodations under the ADA, including for dyslexia, are available (§ 555.18(f)). More in NAB Exam Format and The Core Domains Explained.
The rule calls it the “state examination on nursing facility requirements in Texas” (§ 555.18(a)(1)), and § 555.2 defines it as “The state licensure examination that applicants must pass.” NAB’s handbook lists it as Texas NHA-TX. Every route requires it, including HSE: NAB’s Texas page says “The state regulatory exam is still required.”
| How you take it | After HHSC approves you, register through NAB and schedule with Pearson VUE, as for the NAB exams (§ 555.18(c), (e)). HHSC’s NFA FAQ still names other testing companies; NAB’s current handbook names Pearson VUE, so follow the handbook |
|---|---|
| Time and fee | Two hours: “All state exams have a two-hour time limit.” $210, paid to NAB (NAB handbook; the HHSC fee table agrees). § 555.3(b)(5) and NAB’s Texas page still show $190 |
| Content | “Nursing Facility Requirements for Licensure and Medicaid” (HHSC FAQ): 26 TAC Chapter 554 |
| Questions and passing score | Not published. HHSC and NAB publish no question count, passing score or content outline for this exam. NAB’s handbook says state exams “do not have a consistent passing scaled score” |
| If you fail | You can request, in writing, an analysis of your performance (HSC § 242.307(c)). Pay again for each attempt (§ 555.18(i)). Three consecutive failures of either exam mean another 1,000-hour internship (§ 555.18(j)); HHSC’s pages say “three times” |
| Taking it again later | If your license expired 365 or more days ago (§ 555.36(b) says more than 365), or you surrendered it, you retake the state exam, and the NAB exam too if you passed it more than 5 years earlier (§§ 555.18(k), (l), 555.36(b), (c)) |
HHSC’s FAQ points to 26 TAC Chapter 554, Nursing Facility Requirements for Licensure and Medicaid Certification: the rules a Texas nursing facility runs under. Its subchapters include resident rights (E); admission, transfer and discharge rights in Medicaid-certified facilities (F); abuse, neglect and exploitation (G); nursing services (K); infection control (Q); the physical plant (R); administration (T); inspections and surveys (U); enforcement (V); Alzheimer’s certification (W); Medicaid-certified facilities (X); and PASRR (BB).
Four places where Chapter 554 goes further than, or is more specific than, the federal requirements in 42 CFR Part 483:
| Topic | Federal rule (42 CFR 483) | Texas rule | 26 TAC § |
|---|---|---|---|
| The administrator’s hours | An administrator “Licensed by the State, where licensing is required”; no minimum hours (483.70(d)(2)(i)) | The administrator is “required to work at least 40 hours per week on administrative duties” | 554.1902(b)(3) |
| No administrator in post | No 30-day replacement rule; written notice to the State licensing agency at the time the administrator changes (483.70(j)(2)(iv)) | The facility “must secure a licensed nursing home administrator within 30 days” and notify HHSC “immediately” | 554.1902(a)(1), (2) |
| Director of nursing | Serves full time, unless waived (483.35(b)(2)) | Serves “on a full-time basis, 40 hours per week, except when waived” | 554.1001 |
| Nurse aide in-service training | “No less than 12 hours per year”, including dementia management and abuse prevention; infection control training required but no hours set (483.95(g)(1), (2), (e)) | The same 12 hours a year, of which “at least two hours” must be on infection control and personal protective equipment (PPE) | 554.1001 |
Texas: 26 TAC Chapter 554 (mirror). Federal: eCFR, September 2026.
State NHA Exams Explained covers how state exams work in general.
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Certified preceptors. Your preceptor must be HHSC-certified and serving as NFA of the facility where you train. To find one, ask the NFA Licensing Branch (512-438-2015), administrators you know, and the colleges below.
Colleges. Several Texas schools offer long-term care administration coursework, according to their own pages: McLennan Community College, which says “MCC is an approved preceptor for the required 1,000-hour internship”; San Jacinto College; Tarrant County College; Texas State University (its M.L.T.C.A. degree and a certificate); and Amberton University. University-affiliated internships report by transcript (§ 555.13(a)(5), (7)).
State associations: the Texas Health Care Association and LeadingAge Texas.
For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.
HHSC’s fees are set in 26 TAC § 555.3 and are nonrefundable (§ 555.3(c)); the exam fees are paid to NAB.
| Application | $100 (§ 555.3) |
|---|---|
| License, two years | $250 (§ 555.3) |
| NAB CORE and NHA exams | $480 for the two, paid to NAB |
| Texas state exam | $210, paid to NAB |
| Renewal | $250 every two years (§ 555.3) |
| Late renewal | $375 if 90 days or less late; $500 if 91 to 365 days (§ 555.36) |
| Inactive status | $250 (§§ 555.3(a)(6), 555.38) |
| Reinstatement | $500 (§§ 555.3(a)(7), 555.40) |
Our estimate for a first-time candidate on the standard route: $100 + $480 + $210 + $250 = $1,040, plus fingerprinting and your coursework. Service members, veterans and military spouses can have the application and initial license fees waived (§ 555.42(a) to (c)).
A license “expires two years from the date issued” (§ 555.31(c)), so there is no single statewide renewal date. HHSC notifies you in the portal “at least 31 days before the license expires”, and not getting the notice is no excuse (§ 555.34(a), (b)). To renew you file the form, pay $250, show 40 CE hours and submit fingerprints (§ 555.34(c)); timeliness goes by the date you submit online (§ 555.34(d)).
40 hours, “completed during the previous two-year licensure period” (§ 555.35), which must:
One 3-semester-hour upper-division course waives up to 20 hours (§ 555.35(c)); sponsoring an AIT waives 20 (§ 555.14(f)). The same course counts “only once per license renewal period” (§ 555.35(d)), and HHSC may audit your certificates (§ 555.35(e)). There is no carryover provision in the rule. CE ordered as a sanction does not count toward renewal (HHSC FAQ).
Late renewal is allowed for a year after expiry, with the 40 hours and the late fee. After 365 days you meet the first-license requirements and exams again, and you may not practice while expired (§ 555.36). Inactive status ($250, § 555.38) lets you keep the license without completing CE for up to two renewal periods, per HHSC’s renewal page, but you may not practice while inactive and must show 40 CE hours to renew (§ 555.38(c)); a license that expires while inactive cannot be late-renewed, so you reapply and take the state exam, plus the NAB exams if more than 5 years have passed.
Reciprocity. An administrator licensed in another state files a Reciprocity Licensure Questionnaire (Form 5535), the fee, fingerprints and proof of a license in good standing (§ 555.11(c)), meets the Texas education and internship equivalents (§ 555.12(a)(6)), requests a NAB score transfer (HHSC’s Become page: “Applicant must request their NAB score from NAB”), and passes the Texas state exam (§§ 555.12(a)(6), 555.18).
Provisional license. For administrators licensed in another state with at least one year as administrator of record, sponsored by a Texas NFA unless HHSC waives sponsorship for hardship (§ 555.32; HSC § 242.309, which says two years of licensure rather than one year as administrator of record). It “expires 180 days from the date of issue”, and missing internship hours are completed under an HHSC-certified preceptor. The sources differ on timing: § 555.32(a)(4)(C) lists passing the NAB and state exams as a prerequisite, while HHSC’s Become page requires a NAB pass first and the state exam within the 180 days, and PL 2023-18 (revised 4 January 2024) requires a NAB pass and all Texas requirements met by day 180. The fee differs too: $250 plus the $100 application in the rule, $100 in the HHSC FAQ. Confirm both with the NFA Licensing Branch.
Reinstatement. A former Texas licensee who holds a license in good standing in another state and practiced there for the preceding 2 years can get a new license without re-examination, for $500 (§ 555.40).
Military. § 555.42 gives active service members two extra years to meet renewal requirements, and lets service members, veterans and spouses renew an expired license within 5 years. A military spouse licensed in a substantially equivalent state may practice after HHSC verification; that license “expires three years from date of issuance”, or when the service member leaves Texas if sooner, and “may not be renewed” (§ 555.42(g)(5)).
The legal sources for NFA licensure in Texas, the facility rules the state exam draws on, and the other sources cited above.
Citations verified September 2026. The official Texas viewers load by script, so mirror copies are labeled. Provided for reference, not legal advice; the current official text governs.
1,000 hours on the standard route (a bachelor’s plus 12 semester credit hours in long-term care administration), 500 hours on three routes that combine a qualifying degree with experience, and none for holders of NAB’s HSE qualification (26 TAC § 555.12).
On the degree routes, the NAB Core of Knowledge and NHA Line of Service exams (a scaled 113 to pass each, $480 for the two) and the Texas state exam, two hours and $210, all through NAB and Pearson VUE after HHSC approval. HSE holders take only the state exam (§ 555.18).
HHSC says it covers “Nursing Facility Requirements for Licensure and Medicaid”, which is 26 TAC Chapter 554. No question count, passing score or outline is published. Three consecutive failures of either exam mean another 1,000-hour internship (§ 555.18(j)).
40 hours per two-year license, including at least 6 in ethics, the HHSC infection control and PPE course, and at least one NAB domain (26 TAC § 555.35).
Yes, by reciprocity, if you meet the Texas education and internship equivalents and pass the Texas state exam (§ 555.12(a)(6)). A 180-day provisional license is available to administrators with a year as administrator of record elsewhere and a Texas NFA as sponsor, unless HHSC waives sponsorship for hardship (§ 555.32).
Your preceptor must be HHSC-certified, licensed five years with the last two in Texas (§ 555.15). To find one, ask the NFA Licensing Branch and colleges such as McLennan Community College.
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